How much personal info do you share with pts?

Nurses Relations

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I am a second year RN student. I have had some really nosy, pushy patients the last couple of weeks and it has made me wonder where to draw the therapeutic communication / your asking me too many personal questions line. I know as nurses we are supposed to have a therapeutic relationship with our patients, but at the same time are not supposed to get too close, or share too much with the pt. It seems like in order to have a therapeutic relationship with your pt that you need to be somewhat open with them. Where do you draw the line?

My instructors say that we should easily be able to sit down with the patient and interview them for our care plan. This includes their relationship status, if they are happy in the relationship, if they have kids, job status/ financial status, personal stressors and so on... These questions seem pretty personal to me, but I understand why I am supposed to ask them.

Well, lately my patients have been starting to ask me personal questions.I am talkative and outgoing, but usually prefer to keep to stick to topics like movies, weather, pets, and just small talk. I have never been comfortable discussing things like my relationship, kids, or what neighborhood I live in with people I don't know. Am i just too sensitive? are these normal things people talk about with strangers?

I am sort of torn because I feel like if I flat out refuse to tell them anything that they may not want to keep talking to me, and that is not fostering a good nurse patient relationship. But on the other hand I feel like the pt probably does not see anything wrong with asking me stuff since I was just interviewing them. So, how much do you share with your patients?

On another side note, what is a nice way to tell a patient that you don't want to answer their question if giving a vague answer and changing the subject does not work. For example, a patient asked me where I live the other day. I said "oh, not too far from here. Where do you live."

Pt- "I live on x st and w st. Where exactly do you live again?"

Me- "sort of by the west side, can I get you anything before I go to lunch"

pt- "no I don't need anything. Where exactly do you live, like what streets?"

I just excused myself at that point without answering. What would have been a good way to handle this?

Specializes in Emergency.

I'm always intentionally vague when patients ask me these kinds of questions.

Even though our badges don't have our last names on them, discharge paperwork does. A couple of months ago, we had a patient who was quite nice and very smart and chatty, but seemed to be so smart that she had trouble with social interactions and knowing what was appropriate. Well, she and one of our nurses bonded over their mutual love of cats. Patient is discharged (not by RN who loves cats). A couple of weeks later, former patient mails photos of her cats to RN who likes cats. She somehow got her last name, looked her up on the state website, then looked her up in the phonebook & got her address. Can you imagine if this was someone who wasn't well intentioned? Creeps me out.

I graduated from nursing school two years ago, and we never had to ask patients personal questions, especially concerning their finances, to do care plans. Most information is already available in their charts anyway. Just remember if you ask personal questions you do open the door for personal questions to be asked of you.

Maybe that's why the patients are asking. I've never had any nurse ask me my financial status, what kind of job I have or what my relationship status is. IMO that is rather intrusive and I for one, would tell any nurse that asked me it was none of their business.

Specializes in Gerontology, Med surg, Home Health.

Years ago when I worked in the hospital I didn't share much personal information with patients. In long term care, the patients are there for a long time. They are honestly interested in the people who take care of them. The staff bring their kids in frequently ...it's a different environment.

Specializes in Medical Oncology, Alzheimer/dementia.

I work in a children's hospital, so I don't mind saying I have kids. I wear my wedding ring. Sometimes I might get a mom who's interested in being a nurse ask me where I went to nursing school. If a patient has my same birthdate I'll tell them that, it's a nice ice breaker and kids love when someone else has their birthday. That's about all. Anything more would be too personal in my opinion. I also don't have loads of time to get much in depth.

And on a side note, I don't share much with my co-workers either.

I pick and choose what pts I'm comfortable sharing personal info with. Usually a situation I can relate to. Sometimes our patents need to feel comfortable enough to give us true information and sometimes they need to feel their not alone in their struggles or ailments..

Name. rank, and serial number. According to "Hogan's Heroes" that's all the Geneva Convention requires.

Maybe that's why the patients are asking. I've never had any nurse ask me my financial status, what kind of job I have or what my relationship status is. IMO that is rather intrusive and I for one, would tell any nurse that asked me it was none of their business.

I totally agree. It is not something I am quite comfortable asking, but I do to please my clinical instructor. I do not think that is something I will continue when I get my RN license and work on my own. I do think it opens the door to the pts asking me questions back, and I'm not comfortable answering them either! Oh well, school is a short time and this will be over soon.

However, I am grateful this situation has made me think about where I will set my limits as a nurse.

Specializes in nursing education.

Depends on the relationship with the patient. I've learned to let my affect and manner set the stage for not sharing much and people respect that. In primary care though we might see the same person repeatedly over a period of years and I feel comfortable sharing a little bit with them, but only as it really pertains to the conversation, and put it right back on them. It gets much easier over time. It just is kind of a double standard that we ask all these questions and then not share about ourselves.

And just wait until the "who are you going to vote for!"

When people ask for information or for actions that may breach the necessary boundaries of the nurse-patient relationship, I simply state that it is against my work policy to disclose that information or to do that for them. For example, my patient asked me to come over for dinner (I do home visits for TB case management), and I sincerely thanked them for the invite, but said that, unfortunately, it was against my work's policy to establish a social relationship with my patients. Rather than avoiding the question, you could try explaining why you can't answer the question, as awkward as it may be. Good luck.

Specializes in Med Surg.

I totally agree. It is not something I am quite comfortable asking, but I do to please my clinical instructor. I do not think that is something I will continue when I get my RN license and work on my own. I do think it opens the door to the pts asking me questions back, and I'm not comfortable answering them either! Oh well, school is a short time and this will be over soon.

However, I am grateful this situation has made me think about where I will set my limits as a nurse.

Quite honestly, I made up some of the financial stuff when I was in nursing school. My instructors never watched me ask. It's highly inappropriate. The pt's ability to pay or how much money that make is between them and the business office or social workers, not the nurse. On our intake forms at our hospital we're supposed to ask highest educational level achieved, which seems odd. Yes, I need to know how to best educate my patients, but with a little bit of conversation you can figure that out.

I understand the need to ask about a support person, whether that's a spouse, child, friend, etc.

I share what I'm comfortable sharing. I don't have a problem telling people I'm married, don't have kids, etc. I don't get in depth, but do find sharing a little bit about myself helps pts feel more comfortable. The questions you got are weird, though. I would never give out my street!

Agree. I am a pretty open person. People tend to like me and want to know things. IDK, I play it by ear, but I also limit things, primarily in order to get back to the patient and their needs/issues.

That's really what you have to do. You have to pleasantly bring it back to them---and really, that's what most people like to talk about the most--themselves. ;)

So be friendly, but redirect back to the health issues and needs of the patient. I mean I like to chat too, but there are always other patients and things going on, so you really don't have time to get sucked into such things. More than feeling like the person is a stalker, I would be concerned about time-mgt issues.

Have you not had the course that teaches you about therapeutic communication with clients/patients? (I think it was taught in a nursing fundamentals course, or something like that. It's been a long time.) If so, review that material. Seriously, don't just pass over it. There's good stuff in there, and I honestly have used many of those techniques quiet effectively over the years as a nurse. In fact, I remember we were tested on it throughout the rest of our time in the program; i.e., questions pertaining to therapeutic interactions came up on every test until the end, and as I recall, they were even on state board exams. But that was in the day when you had to sit for two days worth of testing and zillions of questions. Still, I remember it was a big piece in our program.

Good luck.

In nursing school, my patients "refused to answer" a few questions. Generally the ones that were inappropriate. Like the "Are you satisfied with your sex life" to the guy that was in for hip surgery. If he's not, he can ask his PCP. It's not like his orthopedic surgeon is going to order a urology consult and get him some Viagra if he says he's unsatisfied.

How much I share depends on the patient. I'm careful with what I disclose, but I will share little things. I'm totally borrowing that "witness protection" line though! I like that!

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